The word gait refers to the manner in which a person or animal walks or runs. Often, gait reflects a person's mood or purpose of the moment — for example, agitated or impatient pacing; a thoughtful, slow-paced stroll; a determined, brisk walk; or a young child's lighthearted skip. All of these different gaits are voluntary and each can be changed at will.

In some instances, however, a person may lose control over his or her manner of walking. Overindulgence in alcohol, for example, can produce a staggering walk. And, in some cases, the change in gait may be a symptom of a disease.

Causes of gait changes

ArthritisSeveral forms of arthritis can alter the way a person walks. Spinal arthritis can distort the back, forcing the person to walk with a pronounced stoop. Arthritis of the feet, ankles, or hip joints can produce limping. Other symptoms may include joint swelling and distortion, inflammation, and pain.

Back and spine disordersThe spine, which is made up of a series of vertebrae that protect the spinal cord, enables a person to stand upright and to assume various postures. Almost any back disorder affects the ability to walk. In some cases, back pain interferes with walking— a ruptured spinal disk is a common cause of such problems. In other instances, degeneration of, or injury to, the spinal cord or the nerves radiating from it can result in paralysis or difficulty in walking. Osteoporosis, a thinning of the bones that is most common in older women, causes compression and shortening of the spinal column. This results in a humped back and a stooped walk. In younger people,scoliosis — an abnormal curvature of the spine — can result in walking problems. Any back injury or disease affecting the spinal cord can cause irreversible paralysis or problems in walking.

Gait changes are often due to nerve problems in the back

Balance disordersAny disturbance in the balance center, which is in the inner ears, can result in difficulty in walking. Other symptoms such as dizziness, vertigo, and nausea point to the inner ear as the source of a balance and walking problem.

FootdropWhen the nerves that control ankle movement degenerate or are compressed, the person loses control over ankle and foot movement — a condition referred to as footdrop. In order to walk, the person either shuffles along or lifts the foot high and then brings it down with a slapping motion.

Guillain-Barre syndromeThis disease damages the myelin tissue that protects nerve cells. It usually develops after a viral infection; symptoms come on suddenly, and include numbness and even paralysis, usually beginning in the legs and moving upward. Most people recover, but in a small percentage of people, the disease causes permanent nerve damage.

Huntington's diseaseThis is a hereditary disease that causes progressive nerve, muscle, and brain deterioration. As the disease progresses, the muscles become contorted and the person loses ability to control movement. Early symptoms include stumbling and jerking movements.

Lou Gehrig's diseaseThe medical name for this disease is amyotrophic lateral sclerosis, but it is commonly referred to as Lou Gehrig's disease, named for one of its most famous victims. It also is a progressive disease affecting the motor neurons, the nerves that control muscle movements. Early symptoms include stumbling and difficulty in walking.

Muscular dystrophiesThese are inherited diseases that affect males and entail progressive deterioration of muscles. A shuffling gait or frequent stumbling are among the early symptoms. In most types of muscular dystrophy, the person eventually loses ability to walk.

Parkinson's diseaseThis is a brain disease that usually begins after the age of 50 and entails progressive loss of control over balance and movement. Tremors, muscular rigidity, a fixed facial expression, and shuffling walk are among the early symptoms. As the disease progresses, muscles become more rigid and walking becomes difficult.

StrokeA stroke is caused by disrupted blood flow to the brain, either by a blocked artery or a burst blood vessel. Depending upon the part of the brain that is affected, the person may suffer paralysis on one side of the body, affecting the ability to walk.

Advice about gait changes

Physical therapy can often preserve muscle function and delay the effects of progressive diseases, such as spinal arthritis. Braces and other walking aids may also help.

This article was last reviewed October 26, 2005 by Dr.
James Krider.Reproduced in part with permission of Home Health Handbook.